Provider Demographics
NPI:1336292358
Name:FUERST, CINDY TAKIGUCHI (LCSW)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:TAKIGUCHI
Last Name:FUERST
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:
Other - Last Name:TAKIGUCHI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1067 ELA RD
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:IL
Mailing Address - Zip Code:60067-4262
Mailing Address - Country:US
Mailing Address - Phone:630-462-3999
Mailing Address - Fax:630-462-0911
Practice Address - Street 1:610 W ROOSEVELT RD
Practice Address - Street 2:STE B1
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-5087
Practice Address - Country:US
Practice Address - Phone:630-462-3999
Practice Address - Fax:630-462-0911
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical